Women undergoing pelvic brachytherapy: meanings of therapy and its effects

Authors

DOI:

https://doi.org/10.33448/rsd-v11i13.34963

Keywords:

Brachytherapy; Genital Neoplasms, Female; Uterine Cervical Neoplasms; Oncology nursing.

Abstract

This study aims to describe the meaning of pelvic brachytherapy and its effects on the perception of women following treatment. It is narrative research carried out at the Centro de Pesquisas Oncológicas (Santa Catarina/ Brazil), including 34 women with gynecological cancer, in follow-up at the physiotherapy service after the end of treatment. Data collection by semi-structured interview submitted to content analysis. Theoretical framework supported by the Theory of Comfort. Of the results stand out, 88.25% had cervical cancer, mean age of 54.4 years, 26.47% were 30-39 years old, 41.17% had stage IIB, 88.25% had not had a hysterectomy. The meaning found in the narratives declare the difficulties in obtaining the diagnosis, coping with cancer, brachytherapy and adverse effects such as genito-urinary, intestinal and sexual changes causing impaired comfort and/or discomfort. Professional support and self-care are perceived as an aid to comfort. The waiting room means comfort or discomfort. Conclusion: it appears that the meanings of therapy and its effects show the confrontations experienced and that women need professional support, which reinforces the importance of health education and clinical evaluation during and after brachytherapy for prevention, control, self-care of adverse effects and cancer care for better quality of life. To reduce discomfort, clinical interventions and the use of educational technologies can provide better relief, tranquility and favor the transcendence of women with gynecological cancer.

Author Biographies

Maria Eduarda Hames, Universidade Federal de Santa Catarina

Enfermeira. Laboratório de Ensino, Pesquisa e Extensão: atenção interdisciplinar em cuidados paliativos e oncologia. Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brasil

Luciana Martins da Rosa, Universidade Federal de Santa Catarina

Enfermeira. Doutora em Enfermagem. Professora do Departamento de Enfermagem e do Programa de Pós Graduação Gestão do Cuidado em Enfermagem. Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil

Mirella Dias, Centro de Pesquisas Oncológicas

Fisioterapeuta. Doutora em Ciências Médicas. Centro de Pesquisas Oncológicas. Florianópolis, Santa Catarina, Brasil.

Professora do Curso de Graduação em Fisioterapia, Universidade Estadual de Santa Catarina, Florianópolis, Santa Catarina, Brasil.

Ana Izabel Jatobá de Souza, Universidade Federal de Santa Catarina

Enfermeira. Doutora em Enfermagem. Professora do Departamento de Enfermagem e do Programa de Pós Graduação Gestão do Cuidado em Enfermagem. Universidade Federal de Santa Catarina, Enfermagem, Florianópolis, Santa Catarina, Brasil.

Vera Radünz, Universidade Federal de Santa Catarina

Enfermeira. Doutora em Enfermagem. Laboratório de Tecnologia, Pesquisa e Inovação: Cuidando & Confortando, Universidade Federal de Santa Catarina. Florianópolis, Santa Catarina, Brasil.

Maristela Jeci dos Santos, Centro de Pesquisas Oncológicas

Enfermeira. Doutoranda do programa de pós graduação e gestão em enfermagem, modalidade profissional. Mestre em Enfermagem. Centro de Pesquisas Oncológicas. Florianópolis, SC, Brasil

Tomaz Domingos de Souza Neto, Centro de Pesquisas Oncológicas

Enfermeiro. Centro de Pesquisas Oncológicas. Florianópolis, Santa Catarina, Brasil

References

Araujo, C. R. G., Rosas, A. M. M. T. F., Menezes, H. F., Pinto, A. C. S., & Rodrigues B. M. R. D. (2017). The phenomenon lived by women in nursing consultation in the gynecological brachytherapy. Texto & contexto enfermagem, 26(2), e00140016. https://doi.org/10.1590/0104-07072017000140016

Araújo, C. R. G., Rosas, A. M. M. T. F., Menezes, H. F., Cunha, M. A. de L. C., Santiago, A. da S., & Rodrigues, B. M. R. D. (2018). The Meaning of Pain for Women in Gynecological Brachytherapy: Phenomenological Approach in Nursing Consultation. Revista de Pesquisa Cuidado é Fundamental Online,10(3), 612-618. https://doi.org/10.9789/2175-5361.2018.v10i3.612-618

Asssenço, K. C., Kluthcovsky, A. C. G. C., & Mansani, F. P. (2017). Atraso no diagnóstico e tratamento de pacientes com câncer de colo de útero atendidas pelo Sistema Único de Saúde em um centro de referência do Sul do Brasil. O Mundo Da Saúde, 41(4), 692-702. https://doi.org/10.15343/0104-7809.20174104692702

Bardin, L. (2011). Análise de conteúdo. São Paulo, Brasil: Edições, 70, 225.

Bedell, S. L., Goldstein, L. S., Goldstein, A. R., & Goldstein, A. T. (2020). Cervical Cancer Screening: Past, Present, and Future. Sexual medicine reviews, 8(1), 28-37. https://doi.org/10.1016/j.sxmr.2019.09.005.

Chargari, C., Deutsch, E., Blanchard, P., Gouy, S., Martelli, H., Guérin, F., Dumas, I., Bossi, A., Morice, P., Viswanathan, A. N., & Haie-meder, C. (2019). Brachytherapy: an overview for clinicians. Ca: A Cancer Journal for Clinicians, 69(5), 386-401. https://doi.org/10.3322/caac.21578

Chen, J., Zhang, N., Liu, Y., Han D., Mao, Z., Yang, W., & Cheng, G. (2021). Analysis of Applicator Insertion Related Acute Side Effects for Cervical Cancer Treated With Brachytherapy. Frontiers In Oncology, 11, e677052. https://doi.org/10.3389/fonc.2021.677052

Corpes, E., Gonçalves, G., Oliveira, A., Pacífico, V., Castro, R., de Almeida, P., & Barbosa, I. (2022). Repercussões da braquiterapia sobre qualidade de vida e funcionalidade no tratamento do câncer de colo uterino. Cogitare Enfermagem, 27. http://dx.doi.org/10.5380/ce.v27i0.80960

Cullen, K., Fergus, K., Dasgupta, T., Fitch, M.,Doyle, C., & Adams, L. (2012). From "sex toy" to intrusive imposition: a qualitative examination of women's experiences with vaginal dilator use following treatment for gynecological cancer. The journal of sexual medicine, 9(4), 1162-1173. https://doi.org/10.1111/j.1743-6109.2011.02639.x

Dias, M., Roussenq, S. C., Rezende, L. F., & Lenzi, J. (2021). Low level Laser therapy in radiation-induced vaginal stenosis after cervical cancer treatment: Case Report/ Terapia a laser de baixa potência na estenose vaginal induzida por radiação após tratamento do câncer cervical: relato de caso. Brazilian Journal of Development, 7(4), 35230-35240. https://doi.org/10.34117/bjdv7n4-133

Duarte, É., Rosa, L., Radünz, V., Dias, M., Silva, R., Lunardi, F., & Pessi, M. (2020). Mulheres em braquiterapia pélvica: (des)conhecimento e atenção profissional como significado. Cogitare Enfermagem, 25. http://dx.doi.org/10.5380/ce.v25i0.68406

Ehlers, A., & Makanjee, C. R. (2018). Exploration of gynaecological cancer high dose-rate brachytherapy treatment: a pilot study. Pan African Medical Journal, 30(27). https://doi.org/10.11604/pamj.2018.30.27.14608

Ferlay, J., Ervik, M., Lam, F., Colombet, M., Mery, L., Piñeros, M., Znaor, A., Soerjomataram, I., & Bray F. (2020). Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer.

Haddad, N. C., Soares Brollo, L. C., Pinho Oliveira, M. A., & Bernardo-Filho, M. (2021). Diagnostic Methods for Vaginal Stenosis and Compliance to Vaginal Dilator Use: A Systematic Review. The journal of sexual medicine, 18(3), 493-514. https://doi.org/10.1016/j.jsxm.2020.12.013

Humphrey, P., Bennett, C., & Cramp, F. (2018). The experiences of women receiving brachytherapy for cervical cancer: A systematic literature review. Radiography (Lond), 24(4), 396-403. 10.1016/j.radi.2018.06.002

Humphrey, P., Dures, E., Hoskin, P. & Cramp, F. (2021). Brachytherapy for locally advanced cervical cancer: A survey of UK provision of care and support. Radiotherapy and oncology: journal of the European Society for Therapeutic Radiology and Oncology, 159, 60-66. https://doi.org/10.1016/j.radonc.2021.03.007

Kim, Y. A., Yang, M. S., Park, M., Choi, M. G., Kim, S. Y., & Kim, Y. J. (2021). Brachytherapy utilization rate and effect on survival in cervical cancer patients in Korea. Journal of gynecologic oncology, 32(6), e85. https://doi.org/10.3802/jgo.2021.32.e85

Kolcaba, K. (2003). Comfort theory and practice: a vision for holistic health care and research. New York: Springer Publishing Company.

Kpoghomou, M. A., Geneau, M., Menard, J., Stiti, M., Almont, T., & Ghose, B., et al. (2021). Assessment of an onco-sexology support and follow-up program in cervical or vaginal cancer patients undergoing brachytherapy. Support Care Cancer, 29(8), 4311-4318. https://doi.org/110.1007/s00520-020-05898-9.

Lima, L. C. de, Silva, T. S. da, Negreiros, A. S. V. de, Vieira, A. C. Q., Lima, S. C. de, Uchôa, S. M. de M., Uchôa, Érica P. B. L., & Carvalho, V. C. P. de. (2021). Disfunções do assoalho pélvico pós radioterapia para tratamento do carcinoma de colo uterino: uma revisão integrativa. Research, Society and Development, 10(14), e356101422036. https://doi.org/10.33448/rsd-v10i14.22036

Long, D., Friedrich-Nel, H. S., & Joubert, G. (2016). Patients' informational needs while undergoing brachytherapy for cervical cancer. International journal for quality in health care: journal of the International Society for Quality in Health Care, 28(2), 200-208. https://doi.org/10.1093/intqhc/mzv119

Martins, J., Vaz, A. F., Grion, R. C., Costa-Paiva, L., & Baccaro, L. F. (2021). Topical estrogen, testosterone, and vaginal dilator in the prevention of vaginal stenosis after radiotherapy in women with cervical cancer: a randomized clinical trial. BMC cancer, 21(1), 682. https://doi.org/10.1186/s12885-021-08274-w

Mishra, N., Singh, N., Sachdeva, M., & Ghatage, P. (2021) Sexual Dysfunction in Cervical Cancer Survivors: A Scoping Review. Women's Health Reports, 2(1), 594-607. https://doi.org/10.1089/whr.2021.0035

Nascimento, K. C. do, Modesto, F. C., Carvalho, R. B. de M., Ferreira, K. R., Lopes Souza, P., & Silva, G. T. (2021). Adherence to physiotherapeutic guidelines in the prevention of vaginal stenosis after brachytherapy in the treatment of cervical cancer. Research, Society and Development, 10(5), e19010514876. https://doi.org/10.33448/rsd-v10i5.14876

Nurkic, S. R., Ocampo, A. I., Pinell Gadea, M. J., Greenwalt, J., Vicente, M. J., Velasquez, A. L., & Yeung, A. (2018). Implementation of High Dose-rate Brachytherapy for Cervix Cancer in a Low-income Country. Annals of Global Health, 84(4), 679-682. http://doi.org/10.29024/aogh.2377

Pereira, C. S. C. N., Mercês, C. A. M. F., Lopes, R.O.P., Souza, J. F., Souto, J. da S. S., & Brandão, M. A. G. (2020) Análise do conceito de conforto: contribuições para o diagnóstico de Disposição para Conforto melhorado. Escola Anna Nery. 24(2), e20190205. https://doi.org/10.1590/2177-9465-EAN-2019-0205

Ribeiro, K. G., Andrade, L. O. M., Aguiar J. B., Moreira, A. E. M., & Frota, A. M. (2018). Educação e saúde em uma região em situação de vulnerabilidade social: avanços e desafios para as políticas públicas. Interface - Comunicação, Saúde, Educação, 22(1), 1387-1398. https://doi.org/10.1590/1807-57622017.0419

Romano, K. D., Hill, C, Trifiletti, D., Peach, M. S., Horton, B. J., & Shah, N., et al. (2018). High dose-rate tandem and ovoid brachytherapy in cervical cancer: dosimetric predictors of adverse events. Radiation Oncology, 13(129), 1-10. https://doi.org/10.1186/s13014-018-1074-2

Rosa, L. M. da, Lunardi, F., Hames, M. E., Miranda, G. M., Santos, M. J. dos, & Arzuaga-Salaza, M. A. (2022). Avaliação da dor em mulheres com câncer cérvico-uterino durante a braquiterapia. Cogitare Enfermagem, 27, e82535. http://dx.doi.org/10.5380/ce.v27i0.82535

Rosa, L. M., Duarte, É. B., Hames, M. E., Radünz, V., Dias, M., Bagio, C. B., & Arzuaga, M. A. (2021). Mulheres com câncer ginecológico: significado da braquiterapia. Ciência, Cuidado E Saúde, 20, e56295. https://doi.org/10.4025/ciencuidsaude.v20i0.56295

Sekse, R., Dunberger, G., Olesen, M. L., Østerbye, M., & Seibaek, L. (2019). Lived experiences and quality of life after gynaecological cancer-An integrative review. Journal of clinical nursing, 28(9-10), 1393–1421. https://doi.org/10.1111/jocn.14721

Silva, R. H. da, Rosa, L. M. da, Dias, M., Salum, N. C., Varela, A. I. S., & Radünz, V. (2021). Práticas de autocuidado e os efeitos colaterais imediatos em mulheres com câncer ginecológico em braquiterapia. Revista de Enfermagem da UFSM, 11, e35. https://doi.org/10.5902/2179769248119

Soares, M. L. C. A., Trezza, M. C. S. F., Oliveira, S. M. B. de, Melo, G. C. de, Lima, K. R. S., & Leite, J. L. (2016). The healing cost: comfort and discomfort experiences of women undergoing brachytherapy. Escola Anna Nery - Revista de Enfermagem, 20(2), 317-323. https://doi.org/10.5935/1414-8145.20160043

Spampinato, S., Fokdal, L. U., Pötter, R., Haie-Meder, C., Lindegaard, J. C., Schmid, M. P., et al. (2021). Risk factors and dose-effects for bladder fistula, bleeding and cystitis after radiotherapy with imaged-guided adaptive brachytherapy for cervical cancer: An EMBRACE analysis. Radiotherapy and oncology: journal of the European Society for Therapeutic Radiology and Oncology, 158, 312-320. https://doi.org/10.1016/j.radonc.2021.01.019

Tong, L., He, M., Zou, Y., & Li, Z. (2021). Effects of bundled nursing combined with peer support on psychological state and self-efficacy of patients with cervical cancer undergoing chemotherapy. American journal of translational research, 13(9), 10649-10655.

Westerveld, H., Nesvacil, N., Fokdal, L., Chargari, C., Schmid, M. P., & Milosevic M., et al. (2020). Definitive radiotherapy with image-guided adaptive brachytherapy for primary vaginal cancer. The Lancet. Oncology, 21(3), e157-67. doi: https://doi.org/10.1016/S1470-2045(19)30855-1

Wilson, L., & Kolcaba, K. (2004). Practical application of comfort theory in the perianesthesia setting. Journal of perianesthesia nursing. 19(3), 164-173. https://doi.org/10.1016/j.jopan.2004.03.006

Zarzycka, B., & Zietek, P. (2019). Spiritual Growth or Decline and Meaning-Making as Mediators of Anxiety and Satisfaction with Life During Religious Struggle. Journal of religion and health. 58(4), 1072-1086. https://doi.org/10.1007/s10943-018-0598-y

Published

09/10/2022

How to Cite

HAMES, M. E.; ROSA, L. M. da; DIAS, M.; SOUZA, . A. I. J. de; RADÜNZ, V. .; SANTOS, M. J. dos .; NETO, T. D. de S. Women undergoing pelvic brachytherapy: meanings of therapy and its effects. Research, Society and Development, [S. l.], v. 11, n. 13, p. e341111334963, 2022. DOI: 10.33448/rsd-v11i13.34963. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/34963. Acesso em: 26 nov. 2024.

Issue

Section

Health Sciences